In addition to the disseminated intravascular coagulation (DIC) in which coagulation activity is dominant, enhanced fibrinolytic type DIC is known as the DIC. In particular, in the DIC associated with acute promyelocytic leukemia (APL), it is assumed that enhanced fibrinolytic type DIC occurs. In the enhanced fibrinolytic type DIC, the lytic action is enhanced to an extent greater than the extent of thrombus formation, thus presenting bleeding symptoms. However, the conventional DIC treatment is an anticoagulation treatment of administering heparin for thrombolysis, and such treatment may not be suitable for the enhanced fibrinolytic type DIC. As symptoms differ depending on the underlying disease, it is important to classify the DIC into to the DIC in which the coagulation activity is dominant and the enhanced fibrinolytic type DIC, and determine the treatment policy.
For example, “3. Antifibrolytic agent (adaptation and usage of hemostatic and antifibrolytic agent),” The Journal of Japanese Society on Thrombosis and Hemostasis Vol. 20 (2009), by Hidesaku ASAKURA et al., The Japanese Society on Thrombosis and Hemostasis discloses use of a fibrin and fibrinogen degradation product (FDP) concentration and an FDP/D dimer ratio for the determination of the enhanced fibrinolytic type DIC. More specifically, “3. Antifibrolytic agent (adaptation and usage of hemostatic and antifibrolytic agent),” The Journal of Japanese Society on Thrombosis and Hemostasis Vol. 20 (2009), by Hidesaku ASAKURA et al., The Japanese Society on Thrombosis and Hemostasis discloses the following conditions for examination finding in the guideline for carrying out the diagnosis of disease conditions of the enhanced fibrinolytic type DIC. Hereinafter, DD refers to a D dimer. Examination findings: Two or more of the following are satisfied.
1) FDP ≥80 μg/ml
2) fibrinogen <100 mg/dl
3) High value of FDP/DD ratio (low value of DD/FDP ratio)
If the diagnosis of disease conditions of the enhanced fibrinolytic type DIC includes determination on whether or not at least 3) above is satisfied, the FDP measurement and the D dimer measurement are required to obtain the FDP/DD ratio.
As shown in U.S. Patent Application Serial No. 2013/0143243 and US Patent Application Serial No. 2012/0028370, the FDP measurement is carried out using an FDP measuring reagent, and the D dimer measurement is carried out using a D dimer measuring reagent. Thus, different reagents are used for the FDP measurement and the D dimer measurement, so that the measurements are separately carried out.
The FDP measurement and the D dimer measurement are required, as described above, in the diagnosis guideline of the enhanced fibrinolytic type DIC described in “3. Antifibrolytic agent (adaptation and usage of hemostatic and antifibrolytic agent),” The Journal of Japanese Society on Thrombosis and Hemostasis Vol. 20 (2009), by Hidesaku ASAKURA et al., The Japanese Society on Thrombosis and Hemostasis. Thus, at least two measurements are required, which is cumbersome and leads to increase in cost.
Some examination facilities carry out the FDP measurement and the D dimer measurement not simultaneously, or carry out only the FDP measurement and not the D dimer measurement. In this case, it may be cumbersome to carry out the sample analysis that requires the D dimer measurement as in the determination of the enhanced fibrinolytic type DIC.